某三级综合医院鲍曼不动杆菌感染分布及耐药性分析

摘要

Objective To study the infection distribution and drug resistance ofAcinetobacter baumannii (ABA) in a tertiary general hospital,so as to provide basis for effective control of infection and guiding rational use of antibiotics in the clinic.Methods A statistic analysis for specimen sources,distribution departments,and drug resistance of the 551 isolates of ABA were conducted in retrospective manner.Results A total of 551 strains of ABA were isolated form a tertiary general hospital from 2012 to 2014,and the isolated rate increased year by year.The specimens were mainly obtained from sputum and swab,accounting for 77.3％.ABA mainly distributed at intensive care unit (ICU),respiratory department,and neurosurgery department.The resistant rates of ABA to penicillins,cephalosporins,aminoglycosides,and quinolones were over 50％.The resistance rates to imipenem and meropenem were close to 50％.Polymyxin B,minocycline and cefoperazone/sulbactam had better antibacterial activity.The resistant rate increased year by year.Conclusions The infection and resistant rates of ABA shows an increasing tread.It is very necessary to strengthen the monitoring of ABA resistance to guide the rational use of antibiotic drugs for improving the treatment effect and reducing drug resistance rate.%目的 研究某三级综合医院鲍曼不动杆菌的感染分布和耐药性变迁,为有效控制感染和指导临床合理应用抗菌药物提供依据.方法 采用回顾性方法统计分析2012-2014年临床分离的鲍曼不动杆菌的标本来源、感染科室分布及药敏试验结果.结果 2012-2014年某三级综合医院共分离出551株鲍曼不动杆菌,分离率呈逐年上升趋势.标本来源主要为痰和咽拭子等呼吸道标本,占77.3％.科室分布主要为重症监护病房(ICU),其次是呼吸内科和神经外科.鲍曼不动杆菌对青霉素类、头孢菌素类、氨基糖苷类、喹诺酮类耐药率基本在50％以上,亚胺培南和美罗培南等碳青霉烯类耐药率也接近50％,多粘菌素B、米诺环素和头孢哌酮/舒巴坦抗菌活性较好.鲍曼不动杆菌耐药率总体呈逐年上升趋势.结论 鲍曼不动杆菌感染率和耐药率不断上升,因此需要加强该菌耐药性监测,指导临床合理应用抗菌药物,以提高疗效及减缓耐药菌株的产生.